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What is mastitis?

Key points

Mastitis is an infection of the breast tissue that results in swelling and redness. If left untreated, an abscess may form.

Mastitis can develop when bacteria from your baby’s mouth gets into your breast through your nipple during breast-feeding.

Treatment with antibiotics is usually very effective at clearing up mastitis. In some cases, probiotics may be used.

Mastitis is a condition in which a woman’s breast tissue becomes abnormally
swollen or inflamed. It is usually caused by an infection of the breast ducts.
It occurs almost exclusively in women who are breast-feeding.

Mastitis can occur with or without the presence of infection. As it
progresses, mastitis can cause the formation of a breast
abscess.This is a
localized collection of pus within breast tissue. Severe cases of mastitis can
be fatal if left untreated.

Types
of mastitis

Mastitis can occur either with or without infection. If the inflammation
occurs without infection, it is usually caused by milk stasis. Milk stasis is
the buildup of milk within the breast tissue of lactating women. However,
inflammation caused by milk stasis typically progresses to inflammation with
infection. This is because the stagnant milk provides an environment in which
bacteria can grow.

Mastitis caused by an infection is the most common form. Sometimes, a break
in the skin or nipple can develop. Bacteria, usually Staphylococcus
aureus, enter this break and infect the breast tissue, according to
the American
Cancer Society. To fight the infection, the body releases a host of
chemicals, which cause inflammation.

What are the
symptoms of mastitis?

The most common symptoms of mastitis are:

swelling or breast enlargement

redness, swelling, tenderness, or a sensation of warmth
on the breast

itching over the breast tissue

tenderness under your arm

a small cut or wound in the nipple or on the skin of
the breast

fever

What
causes mastitis?

The causes of mastitis include:

Bacterial infection

Bacteria are normally found on the skin. Everyone has them,
and they are normally harmless. But if bacteria are able to break through the
skin, they can cause an infection. If bacteria enter the breast tissue, due to
a break in the skin near or around the nipple, they may cause mastitis.

Obstruction of a milk duct

Milk ducts carry milk from the breast glands to the nipple.
When these ducts are blocked, milk builds up within the breast and causes
inflammation and may result in infection.

Who
is at risk for mastitis?

The following may increase your risk of developing mastitis:

breastfeeding for the first few weeks after childbirth

sore or cracked nipples

using only one position to breastfeed

wearing a tight fitting bra

previous episodes of mastitis

extreme tiredness or fatigue

In these situations, you are at risk of a milk buildup within one or both
breasts, or at risk of infection of the breast tissue.

How is mastitis diagnosed?

Most cases of mastitis are diagnosed clinically. A doctor will ask you
questions about the condition and then give you a physical exam.

The doctor may ask when you first noticed the inflammation and how painful
it is. They will also ask about other symptoms, whether you are lactating, and
whether you are on any medications.

After the physical exam, your doctor will probably be able to tell if you
have mastitis. If you have a severe infection, or if the infection does not
respond to treatment, then your doctor may ask for a sample of breast milk. The
clinic will test the sample to identify the exact bacteria causing the
infection. This will allow your physician to give you the best possible
medication, according to an article in the American Family Physician.

Inflammatory breast cancer can
mimic the symptoms of mastitis. If you are being treated for mastitis and the
symptoms do not improve, your doctor may test for cancer.

How
is mastitis treated?

Treatment for mastitis ranges from antibiotics to a minor surgical
procedure. Some common treatments for mastitis include:

Antibiotics: Certain antibiotics can eradicate the
bacterial infection causing mastitis. You should not take any antibiotics
that have not been prescribed by your physician.

Ibuprofen: Ibuprofen is an
over-the-counter drug that can be used to decrease the pain, fever, and
swelling associated with mastitis.

Acetaminophen: Acetaminophen can also
be used to decrease pain and fever.

Antibiotic treatment usually completely resolves the infection. Breast-feeding
mothers are still able to breast-feed during treatment. The infection is in the
breast tissue and not in the milk. Breastfeeding may also help speed the
treatment process.

Your doctor may recommend that you undergo a surgical procedure called
incision and drainage. During this procedure, the doctor will make a small
incision to help drain any abscesses that have formed due to the infection.

Prevention

The following measures may help prevent mastitis:

taking care to prevent irritation and cracking of the
nipple

frequent breast-feeding

using a breast pump

using a proper breast-feeding technique that allows for
good latching by the infant

weaning the baby over several weeks, instead of
suddenly stopping breast-feeding